The increased changing environmental conditions contribute to multifactorial challenges posed by malnutrition.

The global warming climate has depleted the productivity of soils and the poor who cannot afford high technical farming find it hard to earn quality food products.

Poor environmental conditions may also increase insect and protozoal infections and also contribute to environmental deficiencies in micronutrients.

Overpopulation more commonly seen in developing countries can reduce food production, leading to inadequate food intake or intake of foods of poor nutritional quality.

Conversely, the effects of malnutrition on individuals can create and maintain poverty, which can further hamper economic and social development.

Kwashiorkor and marasmus are the two common protein and energy depleted complaints commonly found in the society. The distinction between the two forms of malnutrition related complaints is based on the swelling of legs or the presence of edema (kwashiorkor) or absence of this edema in case of marasmus.

Marasmus involves inadequate intake of protein and calories, whereas a child with kwashiorkor has fair to normal calorie intake with inadequate protein intake.

Although significant clinical differences between kwashiorkor and marasmus are noted, some studies suggest that marasmus represents an adaptation to starvation whereas kwashiorkor represents a non-adaptation to starvation.

On addition children may be affected by micronutrient deficiencies, which also have a detrimental effect on growth and development.

The most common and clinically significant micronutrient deficiencies in children and childbearing women throughout the world include deficiencies of iron, iodine, zinc, and vitamin A.

Although fortification programs have helped diminish deficiencies of iodine and vitamin A , these deficiencies remain a significant cause of morbidity in developing countries whereas deficiencies of vitamin C, B, and D have improved in recent years.

Micronutrient deficiencies and protein and calorie deficiencies must be addressed for optimal growth and development to be attained in these individuals.

Malnutrition affects virtually every organ system. Dietary protein is needed to provide amino acids for synthesis of body proteins and other compounds that have various functional roles.

Energy is essential for all biochemical and physiologic functions in the body. Furthermore, micronutrients are essential in many metabolic functions in the body as components.

In addition to the impairment of physical growth, cognitive and other physiologic functions, immune response changes occur early in the course of significant malnutrition in a child.

These immune response changes correlate with poor outcomes and contribute to the changes observed in children with acquired immune deficiency syndrome (AIDS).

Recent scientific research also suggests that malnutrition leads to varying malformations to the brain development. These include slowed rate of growth of the brain, lower brain weight, thinner cerebral cortex, decreased number of neurons, and insufficient myelinization.

The adverse effects of malnutrition include physical and developmental manifestations. Poor weight gain and slowing of linear growth occur.

Impairment of immunologic functions in these children mimics those observed in children with AIDS, predisposing them to opportunistic and other typical childhood infections.

Children who are chronically malnourished exhibit behavioral changes, including irritability, apathy and decreased social responsiveness, anxiety, and attention deficits.

In addition, babies and young children who have malnutrition frequently demonstrate developmental delay in delayed achievement of motor skills, delayed mental development, and may have permanent cognitive deficits.

The degree of delay and deficit depends on the severity and duration of nutritional compromise and the age at which malnutrition occurs.

Children are most vulnerable to the effects of malnutrition before the age of five years and early childhood.

Premature infants have special nutritional needs that are not normally met with traditional feeding recommendations; they require fortified human milk. Children are susceptible to malnutrition for differing reasons.

During adolescence, self-imposed dietary restrictions contribute to the incidence of nutritional deficiencies.

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